Active NPI
Irina Fiksman, M.D.
- Psychiatry Physician
- Farmington Hills, MI
National Provider Identifier
1205917028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 045475
- Practice address
- 31500 W 13 Mile Rd
Suite 105
Farmington Hills, MI 48334-2164 - Phone
- (248) 488-8700
- NPI assigned
- Oct 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 045475 | MI | Primary |
Addresses
Primary practice location
31500 W 13 Mile Rd
Suite 105
Farmington Hills, MI 48334-2164
Mailing address
31500 W 13 Mile Rd
Suite 105
Farmington Hills, MI 48334-2164
Phone (248) 488-8700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2606320341 | Other | MI | BLUE CROSS BLUE SHIELD |
| 10 1742611 | Medicaid | MI | |
| 1742611 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045475 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seniors Wellness Group of Michigan, P.C. | Past | Accepting new patients | |
| Mind & Mood Clinic, PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- West Bloomfield, MI
- NPI 1710012372
-
- Clinical Psychologist
- Royal Oak, MI
- NPI 1801848718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465430400000",
"number": "1205917028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31500 W 13 MILE RD",
"address_2": "SUITE 105",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483342164",
"telephone_number": "248-488-8700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31500 W 13 MILE RD",
"address_2": "SUITE 105",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483342164",
"telephone_number": "248-488-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIKSMAN",
"first_name": "IRINA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2016-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "045475",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "2606320341",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10 1742611",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1742611",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.